Introduction: COVID-19 disease has a worse prognosis in patients with diabetes, but comparative data about the course of COVID-19 in patients with type 1 (T1DM) and type 2 diabetes (T2DM) are lacking. The purpose of this study was to find out the relative clinical severity and mortality of COVID-19 patients with T1DM and T2DM.
Material and methods: A nationwide retrospective cohort of patients with confirmed (PCR positive) COVID-19 infection (n = 149,671) was investigated. After exclusion of individuals with unspecified diabetes status, the adverse outcomes between patients with T1DM (n = 163), T2DM (n = 33,478) and those without diabetes (n = 115,108) were compared by using the propensity score matching method. The outcomes were hospitalization, the composite of intensive care unit (ICU) admission and/or mechanical ventilation, and mortality.
Results: The patients with T1DM had higher mortality than the age- and gender-matched patients with T2DM (n = 489) and those without diabetes (n = 489) (p < 0.001). After further adjustment for the HbA(1c), and microvascular and macrovascular complications, the odds of mortality (OR: 3.35, 95% CI: 1.41-7.96, p = 0.006) and ICU admission and/or mechanical ventilation (OR: 2.95, 95% CI: 1.28-6.77, p = 0.011) were significantly higher in patients with T1DM compared to those with T2DM. Older age (OR: 1.06, 95% CI: 1.01-1.12, p = 0.028) and lymphopaenia (OR: 5.13, 95% CI: 1.04-25.5, p = 0.045) were independently associated with mortality in patients with T1DM.
Conclusions: Patients with T1DM had worse prognosis of COVID-19 compared to T2DM patients or those without diabetes. These cases should be cared for diligently until more data become available about the causes of increased COVID-19 mortality in T1DM.
C1 [Demirci, Ibrahim; Haymana, Cem] Univ Hlth Sci, Gulhane Training & Res Hosp, Dept Internal Med, Div Endocrinol & Metab, TR-06010 Ankara, Turkey.
[Tasci, Ilker] Univ Hlth Sci, Gulhane Fac Med, Dept Internal Med, Ankara, Turkey.
[Tasci, Ilker] Univ Hlth Sci, Gulhane Training & Res Hosp, Dept Internal Med, Ankara, Turkey.
[Satman, Ilhan] Istanbul Univ, Fac Med, Dept Internal Med, Div Endocrinol & Metab, Istanbul, Turkey.
[Satman, Ilhan] Hlth Inst Turkey, Inst Publ Hlth & Chron Dis, Istanbul, Turkey.
[Atmaca, Aysegul] Ondokuz Mayis Univ, Fac Med, Dept Internal Med, Div Endocrinol & Metab, Samsun, Turkey.
[Sahin, Mustafa; Emral, Rifat] Ankara Univ, Fac Med, Dept Internal Med, Div Endocrinol & Metab, Ankara, Turkey.
[Ata, Naim] Minist Hlth, Dept Strategy Dev, Ankara, Turkey.
[Unluturk, Ugur; Dagdelen, Selcuk] Hacettepe Univ, Fac Med, Dept Internal Med, Div Endocrinol & Metab, Ankara, Turkey.
[Cakal, Erman] Univ Hlth Sci, Diskapi Yildirim Beyazit Training & Res Hosp, Fac Med, Dept Internal Med,Div Endocrinol & Metab, Ankara, Turkey.
[Sahin, Ibrahim] Inonu Univ, Fac Med, Dept Internal Med, Div Endocrinol & Metab, Malatya, Turkey.
[Celik, Osman] Minist Hlth, Publ Hosp Gen Directorate, Ankara, Turkey.
[Ertugrul, Derun] Univ Hlth Sci, Kecioren Training & Res Hosp, Fac Med, Dept Internal Med, Ankara, Turkey.
[Demir, Tevfik] Dokuz Eylul Univ, Fac Med, Dept Internal Med, Div Endocrinol & Metab, Izmir, Turkey.
[Caglayan, Murat] Ankara Prov Hlth Directorate, Ankara, Turkey.
[Salman, Serpil] Med Clin, Endocrinol & Metab, Istanbul, Turkey.
[Birinci, Suayip] Minist Hlth, Deputy Minister Hlth, Ankara, Turkey.
[Sonmez, Alper] Univ Hlth Sci, Gulhane Fac Med, Dept Internal Med, Div Endocrinol & Metab, Ankara, Turkey.
[Sonmez, Alper] Univ Hlth Sci, Training & Res Hosp, Dept Internal Med, Div Endocrinol & Metab, Ankara, Turkey.